Please enable JavaScript in your browser to complete this form.
LAB Order Form
3 Easy Steps Lab Order Process STEP 1: You will receive an email with your lab order. STEP 2: Bring the lab order to a LabCorp or Quest Diagnostics location for testing and blood draw. STEP 3: Once we receive your results, we will schedule a follow-up call with a provider to review them. Please note: It may take up to two weeks to receive your lab results, depending on the date and location of your blood draw. We will contact you as soon as your results are available for your provider visit. Keep an eye on your email for detailed instructions, check your junk/spam folders.
Please enable JavaScript in your browser to complete this form.
Patient Name
Patient Address
Patient Status
Where do you want to Draw Your Labs?

MEDICAL RECORDS INFORMATION

I Hereby Request That My Medical Records Be Released To:
Medical Records Release Terms & Conditions
1. YOUR AGREEMENT
By clicking "I agree to all and confirm," you affirm that the information you have provided is accurate.

Additionally, you acknowledge that you have thoroughly reviewed and agreed to the Health Care Services Consent, Hormone Replacement Therapy Informed Consent, the Authorization and Consent to Participate in Telemedicine/Telehealth Consultation, the HIPAA Notice of Privacy Practices, and the Self Payment Agreements. You also agree to receive electronic communications from Amazing Meds, understanding that these messages may include personal information, will not be encrypted, and could be accessed by others with access to your email and/or SMS/MMS text message accounts.



By agreeing to this release form, you agree to be bound by, and to comply with, these Terms and Conditions. If you do not agree to these Terms and Conditions, please do not use tick the box.
PLEASE NOTE: We reserve the right, at our sole discretion, to change, modify or otherwise alter these Terms and Conditions at any time. Unless otherwise indicated, amendments will become effective immediately. Please review these Terms and Conditions periodically.